Only a few hours after Florida’s chief economist said the state can’t afford to leave billions of federal dollars sitting on the table, the House committee on the Affordable Care Act voted to do exactly that.
The 10-5 vote fell along party lines, as the Republicans on the committee said they didn’t trust the federal government to come through with the money, given the state of the federal budget. They also expressed an extreme distaste for the Medicaid program, saying it’s far inferior to private insurance.
A Senate committee studying the same issues has not yet voted, but the chairman, Sen. Joe Negron, sounded as though he is leaning toward voting for the expansion.
And a lobbyist for Associated Industries of Florida, which had remained neutral until now, spoke in favor of the expansion.
Here are the details:
Amy Baker, coordinator of the Legislative Office of Economic and Demographic Research, laid out several scenarios based on different assumptions. But they all pointed in the same direction: Florida cannot afford NOT to expand Medicaid, she said.
That’s because the $26 billion in federal funds for Medicaid expansion offsets the costs of implementing the mandatory parts of the Affordable Care Act, Baker said. Most of those costs would fall on the private sector, she said.
“Expansion helps…by mitigating the effects of the mandatory provisions of the law,” Baker said.
The Senate committee’s numbers man, Orlando-area Republican David Simmons, told Baker that her numbers “make sense.” He had already figured out that the state’s employers would be hit if Florida doesn’t accept the federal funds that are being offered, he said.
“The burden on employers if we do not do Medicaid expansion is going to be significant,” he said.
Baker estimated that Florida would lose between $6 billion and $12 billion a year over the next 10 years if it says no to Medicaid expansion. That’s because the expansion is the only part of the Affordable Care Act that is voluntary.
The mandatory parts – that individuals and large businesses carry insurance or pay a penalty – will take effect regardless of the Legislature’s decision on Medicaid, she said. Meanwhile, almost one million low-income people who would have been covered by the new federal funds would remain uninsured, she said.
Currently Florida has just over four million uninsured, Baker said – about 21.4 percent. Under the health law’s provisions, counting Medicaid expansion, that will be cut to under 10 percent, she said.
The newly-covered Medicaid population would be those with incomes of 138 percent of the federal poverty level or less – about $15,000 for an individual. Most of those who would be brought into the program are adults who currently don’t qualify because they don’t have young children at home, Baker said.
Through their questions, some members of both committees indicated they were skeptical of the conclusions. Baker acknowledged there are a number of outcomes that can be forecast, depending on the assumptions used in economic modeling. She said she hopes to have more information by Thursday.
State Sen. Joe Negron, who chaired the joint session, indicated that he agrees with those who favor expanding Medicaid.
“In the end, the issues’s going to come down to weighing values, of having some form of insurance coverage available” for the uninsured, he said.
To those who predict calamity, he said, “Let’s not underestimate the human spirit.” Medicaid expansion may or may not be a good idea, he said, but it would be better to have 7 percent of Floridians uninsured than 21 percent.
—Carol Gentry, Health News Florida